A Tybee Island Sunset, courtesy of Mayra Martin, AFAS Accounts Payable Manager, and proud Tybee resident.

The Critz Tybee Run Fest 2012 is right around the corner, and while many runners will be locals, visiting runners from far away will be taking advantage of all that Tybee Island has to offer. So we’ve whipped up some tips so you can take full advantage of your Tybee Beach Run!

1. Don’t Wear Shoes You Like - Just like New Orleans on Mardi Gras, this is also great advice for beach runs. Try to wear shoes with a smaller mesh to prevent sand in your shoes, but let’s face it, it’s going to happen. And as far as getting all that sand back out of the shoes, well let’s just say those are your designated beach runners from now on.

2. The Tides – Low tide creates hard packed sand, but it’s still better than running on hard pavement. For those running the 5k on Friday night, the tide will just be ebbing low, but don’t worry, that course has no beach route, an advantage shared by all runs except the 2.8 mile Beach Run. You can also expect low tide for the noon start of the Beach Run.

3. Plenty of Fluids - As with any run you need to make sure to replenish precious fluids. But remember running in hard packed sand can be a lot more grueling than your everyday run. Make sure to account for this.

4. Your Knees! – Tides create the gentle slope of the beach, a joy to all those who visit to bask in the sun. Not so for runners, as this can create an uneven running surface, which can wreak havoc on the knees and hips. The higher the high tide, the more extreme you can expect the slope of the beach to be. Running in a zig zag pattern, creating small “uphill” and “downhill” runs, helps to even-out every joint’s stress.

5.Gear Up – Don’t forget the sunblock, and opt for a waterproof or sport one, as these will resist sweat.  Sunglasses and a hat are also a great choice, just because you’re running, it doesn’t make the beach any less bright.  Finally, consider a lubricant like BobyGlide or SportSlick (you can pick these up at Fleet Feet) for your feet and legs, to help prevent sand chaffing.

6. Swim! – You’ve just finished the race, so why not take full advantage of where you are and go for a quick dip to cool off.  Enjoy the chop, but remember that lifeguard season runs from roughly the beginning of May through the end of September, so choose a swimming buddy, that way you won’t be out there on your own!

7.Wind! – Make sure to take in to account the wind on the beach. It can really whip sometimes, so be ready for it to add yet another difficulty factor to you run.

8. Use Dynamic Stretches Before/Static Stretches After the Race – Dynamic stretches increase your range of motion so get your High Knees, Butt Kicks and Low Lunges in before the race. Static Stretches will help you with cool down. Groin Stretches, Calf Stretches and Hamstring Stretches work great for this.

9. Rest Before the Race – Get some rest at one of Tybee’s picturesque beachfront hotels, or chill out with a group of runners  at a cottage of your own from Mermaid cottages.

10. Have a Carbohydrate Heavy Meal the Night Before the Race - Visiting runners be sure to try all the tastes of Tybee like The Sundae Cafe, North Beach Grill, or Lighthouse Pizza. For those adventurous enough to carb load the morning of, make sure to hit up The Breakfast Club.

Atlantic Foot and Ankle Specialists will have a large group running, so make sure to look for our employees in their  ” I LOVE MY FEET” tees! We’ll see you at the Tybee Beach Run!

   While, most orthotics control the arch and heel, for cycling, the rider requires forefoot balancing. Forefoot balancing, unlike in other sports, is critical for the cyclist. The marathon runner disperses his weight in the heel and power from the toe.  In cycling the forefoot transfers all the power from the legs directly into the pedal. The bones in this area of the foot are simply not designed for this amount of pressure like those of the heel.

   The lack of support in your cycling shoes allows the foot to collapse through the arch while pedaling, which may cause arch pain, tendon problems, or burning under the bottom of the foot. This collapsing of the medial arch reduces the amount of downward force applied with every rotation (Australian Case Study). That is simply wasted energy. You don’t train long hard hours just to waste energy.

   Custom made orthotics also protect your feet from the stress of pedaling. Investing in cycling-specific shoes and orthotics is an absolute necessity, especially if you have had preexisting problems with your feet.

Here are some of the most common lower extremity cycling injuries:

• Shin Splints: Pain is typically found mid way between the knee and ankle on either side of the leg bone. It is commonly related to excessive foot pronation (collapsing arch). Proper stretching and corrective orthoses for pronation can help prevent shin splints. It’s recommended to have this condition evaluated by a podiatrist.
• Achilles Tendinitis: Irritation and inflammation of the tendon that attaches to the back of the heel. This condition can be treated with ice, rest, and anti-inflammatory medications. Chronic pain or any swelling should be professionally evaluated by a podiatrist.
• 

  Sesamoiditis

  Sesamoiditis: The sesamoids are two small bones found beneath the first metatarsal bones (The great toe); the sesamoids can become inflamed or rupture under the stress of cycling. Sesamoiditis can be relieved with proper shoe selection and orthoses. Chronic pain should be evaluated by a podiatrist.

• Neuroma:  This is an impingement of small nerve branches between the second and third or third and fourth toes. This impingement can cause swelling that result in numbness, tingling, burning, or sharp shooting pains into the toes. Custom orthotics, wider shoes, or loosening toe straps or shoe laces can alleviate the problem. You can also try a clip less system help with the pain.  If the problem persists, see you local podiatrist.

1. Change Your Running Route to Include More Hills – Remember that the Talmadge Bridge  has an almost 6%  gradient, and your body will use your muscles much differently when tackling this run than your average Lowcountry flat runs
2. Keep a Steady Pace Going Up – While some people think they need to blast through the incline, this ends up being very inefficient and wastes a lot of energy. Save that energy for the decline, when you can use gravity to help really improve your time.
3. Drink Plenty of Fluid Before the Race – Dehydration can cause blood volume to drop off causing your body’s ability to transfer heat to decrease, and speed up your heart beat.
4. Do Not Use Brand New Shoes for the Bridge Run – Make sure to break in new shoes for a period of 1-2 weeks of shorter runs before race day.
5. Make Sure You Get Enough Electrolytes – As you exercise your body will lose sodium through sweat. You can get electrolytes through either tablets, tomato juice, or Gatorade.
6. Rest Before the Race – While you should definitely get lots of rest the night before the race, sometimes pre-race jitters can interrupt your normal sleep pattern. Make sure to get your long nights of sleep the 2-3 days before the race, that way you’ll still have plenty of rest despite those sleepless pre-race nights.
7. Warm Up Using Dynamic Stretches/Static Stretches After the Race – Dynamic stretches increase your range of motion, think Ankle Pops, High Knees, Butt Kicks and Low Lunges. Static Stretches will help with cool down, try Groin Stretches, Calf Stretches and Hamstring Stretches.
8. Have a Carbohydrate Heavy Meal the Night Before the Race - Think pasta. Carbohydrates are a great source of energy, and your body loves this, otherwise your body is forced to use stored fat, which uses more of your bodies energy.
9. Find a Committed Running Partner – Not only can a running partner provide encouragement, but they are also help you improve your form and are great pace setters.
10. Replenish Lost Electrolytes – If memory serves right, the Savannah Bridge Run has free beer after the finish line. One beer after a workout will actually rehydrate you faster than water, because the salts, sugars, and bubbles in beer enhance your body’s ability to absorb the water content!

Now you are ready to conquer the Savannah Bridge Run! We’ll see you at the top!

Remember that pain in your feet and ankles is not normal, so if you are experiencing pain please call Atlantic Foot & Ankle Specialists to schedule an appointment, 912-355-4557 or go to our Appointments page here.

All the doctors have agreed to a friendly competition, whoever receives the most reviews on their Google page wins!

What could be better than that? What if every review you wrote entered you to win a free pair of custom orthotics?!

So if there is one of our doctors in particular that has a special place in your heart, say thank you by writing them an amazing review.

Click on any of the doctors pictures below to review them!

Review Dr. Runkel

Review Dr. Newsom

Review Dr. Robitaille

Review Dr. Jeffress

This fun bun-ion quiz has been brought to you by your friendly neighborhood podiatrist, Dr. Kristian Jeffress, DPM.

1.  What is a bunion?

A bunion is an enlargement of the of the bone and soft tissue surrounding the big toe. This makes your foot look like you have a bump on the inside of the base of your big toe and also causes your big toe to angle toward the second toe.

2.  Where do bunions come from? 

Bunions are genetic progressive deformities.  A common misconception is that bunions form from wearing narrow shoes.  Unless your shoe gear is a constant issue of being too small throughout your entire adolescents, narrow shoes are not the cause of the bunion.  However, it is true that narrow shoes can intensify the severity of bunion formation, but this is typically not the cause.  So this Thanksgiving, be sure to thank your family tree for your bunions.

3.  Who develops bunions?

With bunions being genetic we are all pre-disposed based on our family history to develop bunions.  But, bunions seem to be much more prevalent in women.  Tight fitting shoes such as high heels and narrow toe shoes do increase the severity of bunion formation, thus the high percentage of women that develop bunions over men.

Bunion X-ray

4.   Can bunions be prevented?

Bunions can not be prevented, but the severity of their development possibly can.  Wearing properly fitting shoes can help tremendously in bunion formation.  Your shoes should conform to the shape of your feet and should not constrict your toes.  Custom inserts can also help prevent the rapid development of bunions.

5.  Is surgery needed?

Possibly.  If you develop a bunion that becomes painful and other treatment options have failed, then surgery may be the right option for you.  A bunionectomy is a surgical procedure commonly performed by a podiatrist that helps to straighten out the big toe. As with all problems, the sooner you catch it the easier it is to treat. Don’t simply assume that surgery is required for a bunion. Bunions in very early stages can be controlled with non-surgical means that may even prevent the need for surgery in the future! The best thing you can do is visit with your podiatrist to see what the best options are.

Dr. Christin Runkel, DPM

I spent this past Sunday like many Americans, watching a football game with my family at a local restaurant.  As the referees determined yardage and the players fought to gain it, my attention flew to the actual playing field, the grass beneath their shoes.  Before the introduction of hybrid, genetically improved grasses, the field was made of AstroTurf.  As I glanced around the room during the game, I could not help but wonder how many former football players had suffered from a condition called turf toe. And it just so happens to be Atlantic Foot and Ankle Specialists’ Foot Problem of the Month, so get ready to be conditioned for some knowledge!

Common Turf Toe Injury

Turf toe is a hyperextension injury of the big toe joint where it is bent forcefully upwards. It occurs in people who play contact sports on artificial surfaces, which is how turf toe acquired its name. Today, it typically occurs in athletes who have increased range of motion in the ankle and or wear flexible shoes. The forceful upwards motion of the toe causes ligaments under the toe to be stretched and damage usually occurs to the surfaces of the bones making up the big toe joint.

Symptoms of turf toe include swelling and pain at the big toe joint with tenderness upon stretching the joint upwards. The athlete can initiate treatment by icing the injury, apply a compression bandage, and or wear a shoe with a firm sole that will not allow bending. The next step is to contact a podiatrist with experience in sports medicine. The medical professional will obtain either X-rays or an ultrasound to rule out fracture. A variety of treatments can then be implemented.

Treatments usually include taping/strapping the toe and or orthotics to prevent movement, anti-inflammatory medications (NSAIDS, such as Tylenol) , and beginning a rehabilitation and strengthening program. The recovery period usually takes about 4 weeks, depending on the extent of injury. If the athlete returns to activity prematurely, they may develop hallux limitus, which is arthritis at the big toe joint.

If you or a friend are suffering from turf toe, please contact Atlantic Foot and Ankle Specialists at 912-355-4557. And please feel free to visit our Facebook page and remember to “like” Atlantic Foot and Ankle Specialists.

Jeopardy host Alex Trebek

For some reason, I was not shocked to hear that the Jeopardy host, Alex Trebek took matters into his own hands when his San Francisco hotel room was burglarized late Wednesday night. It was around 2:30 am, Trebek and his wife were asleep, when accused burglar Lucinda Moyers, 56 of San Francisco, awoke Trebek while fleeing the room. Trebek gave chase, and while varying accounts say he either tore, ruptured, or in some cases “snapped” his Achilles, it is clear that the Jeopardy host injured his tendon badly enough to need crutches while hosting the National Geographic World Championship. Cash and a bracelet gifted to Trebek by his mother were among the items stolen, and while the cash was recovered, the cherished bracelet remains missing.

Trebek announced at the National Geographic World Championship that he required surgery and would be in a cast for a period of about 6 weeks. I’ve spoken to the podiatrists and medical assistants here at Atlantic Foot & Ankle and they agree if surgery is required, the injury is most likely a rupture of the tendon. So you may ask yourself, “What exactly is the difference between a tear and a rupture?”

Dr. Melissa Robitaille, DPM

“In a tear, the tendon still retains some integrity. I don’t recommend surgeries for tears.” says Dr. Melissa Robitaille, founder and co-owner of Atlantic Foot & Ankle. “I would recommend a non-weight bearing cast in the plantar-flex position (that’s toes pointing down for you non-podiatrists out there) for about three weeks. Then I would move the patient to a weight baring walking boot and recommend physical therapy.”

A rupture, unfortunately, can be a much longer and more grueling recovery process.

“We would have to repair the tendon in surgery, and cast it for 3-4 weeks. The patient could experience swelling for up to 6 months, along with chronic weakness. Physical therapy would be totally necessary to help regain the lost strength of the tendon.”

“For me, tear and rupture describe the same injury – in other words, there has been damage to the tendon.” said Dr. Todd Newsom.

Dr. Todd Newsom, DPM

“The real issue is whether that tear or rupture is complete or only partial. A partial tear or rupture of the Achilles typically does not require surgery. It’s usually best to treat with conservative measures (e.g. casting alone).

“If the tear or rupture is complete, that is a different decision entirely.” said Newsom. “There’s actually quite a debate whether one should have surgery or conservative treatment for a complete rupture. Many factors including severity, age, occupation and other health risks can all be used to determine which treatment plan would be best.”

It looks like the road to recovery for the 71 year old Trebek may be a long one. His surgery is scheduled for Friday. Trebek plans to continue taping Jeopardy with the aid of crutches in the weeks to follow. Everyone at Atlantic Foot & Ankle wishes the beloved game show host a speedy and successful recovery.

You can read more about the Achilles Tendon here.

Are you unfamiliar with nail fungus?  Nail fungus, AKA Onychomycosis, can be identified by a thickened nail that can appear yellow, cloudy, or darkened.  The nail can also become very brittle and separate from the nail bed.  Yuk!

Here are a few tips to help prevent nail fungus and help your feet enjoy the summer sun:

• Air out your feet – it is very important to let your feet and nails breathe.  Keeping them in dark and damp areas can aid in the development of fungi to grow and spread.

• Spray Lysol or a disinfectant spray in your shoes when not in use – Disinfecting your shoes can help kill any fungus that can hide in the crevasses of the inside of your shoe.

• Avoid pedicures (unless it is completely sterile) – Nail salons can spread nail fungus if the tools are not properly sterilized.  Tools should be sterilized in an autoclave to ensure the spread of fungus will not occur.

• Avoid shared showers – Although some shared showers may look clean, fungi can spread very easily in dark, damp areas.  If you must shower in a public or shared shower, shower shoes are highly recommended.

If you already have signs of nail fungus and need treatment, don’t hesitate to call Atlantic Foot & Ankle Specialists for an appointment!  Enjoy your summer!

1) Use Those Flip-Flops in Moderation

Most flip-flop or sandals don’t have adequate support for your feet. They are ideal for the beach or the pool and even if yo

u know you are not going to be on your feet or walking for an extended period; however, if you are planning on doing a lot of walking or spending the day on your feet, wearing a shoe with more support is critical to avoid possible tendon and ligament strain in your feet, legs and even back. Flip-flops are not built for Disney World!

2) Realize your Feet and Legs Tend To Swell More In Summer

This is due to the increase in temperature along with the possibility you are going to be on your feet more. If possible, elevate your feet above the level of your heart 2-3 times a day, for at least 20 minutes. At the very least, be sure to prop your feet up at the end of the day for 30-45 minutes.

Also, it is important to wear a shoe that fits properly. If you start the day off with a shoe that fits snug, it is likely to be quite uncomfortable by the end of the day. In addition, the tight shoe can cause friction, which could lead to blisters.

Finally, if you are going to purchase shoes, preferably buy them in the late afternoon or evening, since your feet are more likely to be larger at this time of day.

3) Try to Avoid Going Barefoot

The likelihood that you get cuts, scratches, bumps, punctures, and all kinds of other traumas, major or minor are greatly reduced if you are wearing some type of shoe. For example, people, especially kids, are more likely to get warts on the bottom of the feet during the summer, because they step on tiny pieces of glass, wood, or other hazard which, although does not cause a serious puncture wound, is enough to place the virus in the skin. If you were thinking of trying a pair of the those new ‘toe shoes’, now is the time.

4) Trim your Nails Properly

Trim your nails straight across. Do not cut the nails down in the corners. This can lead to ingrowing toenails and infections. If you already are doing this, go see a foot doctor to fix the problem before you hit the beach.

5) Keep your Feet Clean

Wash with soap and water daily. Try not to soak feet, as this removes the skins natural oils. Also, after washing feet, apply a moisturizer to your feet, but avoid between your toes. If you are prone to calluses, hard skin, or cracking heels, you will require a moisturizer that also has an ingredient to specifically soften these areas (will usually be referred to as a keratolytic agent).

6) Careful with Discolored Nails

Dr. Todd Newsom, DPM

Don’t use polish on discolored, cracked, or brittle nails. Your nails may have a fungus, and using polish will likely make the condition worse. Check with your local podiatrist just to be sure. You may need to use a topical medication for a brief time. At the very least, even if you do use that bright-colored summer polish, you will have a plan to keep the condition from worsening.

7) Have/Use a pair of Good Supportive Shoes

As mentioned before, if you are going to be on your feet, like at an amusement park, it is best to have a pair of good supportive shoes to prevent numerous types of foot injuries. You are more likely to experience heel pain if you increase your activities, but are not using a supportive shoe. If you notice heel pain during the day, it is important to get off your feet and rest them. Also, if you do a lot of walking, and the next morning when you wake up you notice you have a lot of pain in your heels, you need to take it easy. Give your feet a rest, do some calf stretches, ice and some massage to keep the condition from getting worse.